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Prevalence of internal hernia following laparoscopic colorectal surgery: single-center report on 1300 patients

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Abstract

Background

Internal hernia (IH) is an infrequent complication following colorectal resection with minimally invasive technique. The real prevalence is difficult to define and there are only few large series reporting data on this complication, often focusing only on left-sided resections. Aim of the study was to evaluate the occurrence of IH following laparoscopic colorectal resection (LCR), reporting clinical presentation and treatment.

Methods

Data from 1297 patients undergoing elective LCR for cancer or benign disease in a 15-year period (June 2005–March 2020) were prospectively collected. A database query was performed to search for small bowel obstructions requiring reintervention.

Results

Five patients presented symptomatic IH (prevalence = 0.38%) and required reintervention. The preceding surgical procedure was left hemicolectomy for diverticular disease in all patients. The mesenteric defect had been originally closed in 4/5 patients. The median time interval between initial surgery and the occurrence of IH was 1 (range: 0.3–10) month. In all cases a small bowel loop was found herniating through the mesocolic defect. Small bowel resection was required in one patient only. The median hospital stay following reintervention was 7 (range: 4–17) days.

Conclusions

IH following LCR is a rare but severe complication, potentially leading to death, if not promptly diagnosed and treated. Awareness of this complication, early recognition, and proper diagnostic and therapeutic management is mandatory allowing laparoscopic approach and often avoiding small bowel resection.

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Authors and Affiliations

  1. Department of General Surgery, ULSS 6 Euganea, Via Casa di Ricovero 40, 35013, Cittadella, PD, Italy

    Giuseppe Portale, Chiara Cipollari, Matteo Zuin, Ylenia Spolverato & Valentino Fiscon

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  1. Giuseppe Portale
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  2. Chiara Cipollari
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  3. Matteo Zuin
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  4. Ylenia Spolverato
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  5. Valentino Fiscon
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Correspondence to Giuseppe Portale.

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Disclosures

Drs. G. Portale, C. Cipollari, M. Zuin, Y. Spolverato and V. Fiscon have no conflict of interest or financial ties to disclose.

Ethical approval

The study was conducted according to the Helsinki Declaration and patients gave their consent to have their data collected for scientific purposes. The study was approved by the local Ethics Committee (4897/U6n/20).

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Portale, G., Cipollari, C., Zuin, M. et al. Prevalence of internal hernia following laparoscopic colorectal surgery: single-center report on 1300 patients. Surg Endosc 35, 4315–4320 (2021). https://doi.org/10.1007/s00464-020-07921-w

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  • DOI: https://doi.org/10.1007/s00464-020-07921-w

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